title: Tooth preservation or implant placement: a systematic review of long-term tooth and implant survival rates.
abstract: BACKGROUND
  For the past few decades, dental implants have served as reliable replacements for missing teeth. However, there is an increasing trend toward replacing diseased teeth with dental implants.
  
  
  METHODS
  The authors conducted a systematic review of long-term survival rates of teeth and implants. They searched the MEDLINE database for relevant publications up to March 2013. They considered studies in which investigators assessed the long-term effectiveness of dental implants or that of tooth preservation. They included only studies that had follow-up periods of 15 years or longer.
  
  
  RESULTS
  The authors selected 19 articles for inclusion. Investigators in nine studies assessed the tooth survival rate, whereas investigators in 10 studies assessed the implant survival rate. When comparing the overall long-term (that is, 15 years or more) tooth loss rate with that of implants, the authors observed rates ranging between 3.6 and 13.4 percent and 0 and 33 percent for teeth and implants, respectively. They could not perform a meta-analysis because of the substantial differences between the studies.
  
  
  CONCLUSIONS
  The results of this systematic review show that implant survival rates do not exceed those of compromised but adequately treated and maintained teeth, supporting the notion that the decision to extract a tooth and place a dental implant should be made cautiously. Even when a tooth seems to be compromised and requires treatment to be maintained, implant treatment also might require additional surgical procedures that might pose some risks as well. Furthermore, a tooth can be extracted and replaced at any time; however, extraction is a definitive and irreversible treatment.
authors.affiliation: Dr. Levin is an assistant professor, Faculty of Medicine, Technion, Israel Institute of Technology, Haifa; Harvard School of Dental Medicine, Boston; Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, P.O. Box 9602, Haifa 31096, Israel, liranl@technion.ac.il.
authors.forename: Liran
authors.initials: L
authors.lastname: Levin
authors.forename: Michal
authors.initials: M
authors.lastname: Halperin-Sternfeld
mesh_terms: D015921:Dental Implants / Q000706:statistics & numerical data*; D006801:Humans; D016388:Tooth Loss / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D015921:Dental Implants
keywords: Hopeless teeth; implant loss; implant placement; implant survival; periodontal disease; periodontitis; tooth extraction; tooth loss